To the uninitiated, physician associates and nurse practitioners seem to serve a similar role, performing many of the general tasks a doctor would perform: prescribing medication, ordering medical tests, and designing treatment plans. They’re not just nurses and associates, but they’re not quite medical doctors either. So what are they exactly, and what’s the difference between them?
While there’s a lot of overlap between the two positions, think of it like this: physician associates go wide, and nurse practitioners go deep. Physician associates are trained to treat a broad spectrum of patients, while nurse practitioners target a specific population. It starts in school, where PAs get a broader education in their graduate programs and nurse practitioners go deep into an area of focus.
This is also reflected in the certification process, where physician associates take a generalist examination for licensure, while nurse practitioners often pursue advanced population-specific certifications. It’s generally easier to switch specialties as a physician associate because a nurse practitioner will need to undergo more formal training requirements and additional certification steps.
But it’s also not quite that simplistic. The differences between these two roles are more nuanced than a sweeping generalization. Subtle variations exist in educational requirements, prescriptive authority, and licensing requirements. Further variation occurs based on one’s specialty, area of practice, and state of residence. To learn more about the way these professions deviate and overlap, check out our side-by-side comparison chart below.
Side-by-Side Comparison: Physician Assistant or Associate vs. Nurse Practitioner
| Physician Assistant or Associate (PA) | Nurse Practitioner (NP) | |
|---|---|---|
| Education | Physician associates will need a bachelor’s degree and a master’s degree (MPAS, MHS, or MMSc) from a PA school. | In addition to a bachelor’s degree in nursing (BSN), over 99 percent of nurse practitioners have either a master’s degree (MSN) or a doctorate (DNP). |
| Timeline to Practice | To practice, a physician assistant typically needs a four-year bachelor’s degree, a two- to three-year master’s degree, and three years of healthcare experience. Allowing for some overlap, the general timeline to practice is between seven and ten years. | To practice, a nurse practitioner typically needs a four-year bachelor’s degree and a two- to four-year graduate-level degree. In general, the timeline for nurse practitioners to practice is six to eight years. |
| Typical Duties | While a physician associate’s duties will vary depending on their specialization and location, a general list would include:
| While a nurse practitioner’s duties will vary depending upon the regulations in their state, a general list would include:
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| Can Prescribe Medications? | Physician associates can prescribe medications in all 50 states, but the specific nature of that prescriptive authority can vary by state. As of 2026, in 47 states, the scope of that prescriptive authority is determined by the supervising physician. Seven states place some regulatory limits on the scope of that authority, particularly regarding the prescription of schedule II and legend substances. | Nurse practitioners can prescribe medications, including scheduled substances, in all 50 states. The specific nature of that prescriptive authority, however, can vary. Some states require that nurse practitioners have “collaborative relationships” with a specific supervising physician in order to prescribe medication, although that is changing. Nurse practitioners may also need to undergo a probationary period and register with the DEA. |
| Common Practice Settings | According to the BLS (2026), over 50 percent of physician associates work in physician offices and clinics, just over a quarter work in hospitals, and 8 percent work in outpatient care centers. | According to the American Association of Nurse Practitioners (AANP), over two-thirds of nurse practitioners work in family care, both in outpatient clinics and primary care settings. They can also work in acute care inpatient settings. |
| Licensing and Certification | Physician associates need to be both state-licensed and certified in order to practice. Certification requires one to pass the 300-question Physician Assistant National Certifying Exam (PANCE), which is administered by the National Commission on Certification of Physician Assistants (NCCPA). Those who pass the exam are eligible to use the Physician Assistant-Certified (PA-C) title. For state licensure, each state has its own eligibility requirements. More information can be found on the American Academy of Physician Assistants (AAPA) website. | Nurse practitioners need to be licensed as both a registered nurse (RN) and a nurse practitioner (NP) in their state. Further certifications and their requirements will vary by specialty and location. The most common certifying organizations are:
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| Continuing Education Requirements | To maintain their certification and licensure, physician assistants are required to complete 100 hours of continuing medical education (CME) every 2 years. Furthermore, they’ll need to pass the Physician Assistant National Recertification Exam (PANRE) every ten years. |
The quantity and cadence of continuing nursing education (CNE or CE) required for nurse practitioners will vary by state and specialty.
Generally speaking, state APRN licenses need to be renewed every one to two years, while specialty certifications are valid for one to five years. The precise amount of CNE required will vary widely. ANCC certifications, for example, are valid for five years, and typically require 75 hours of CNE to renew. |
| Specializations | Physician associates can pursue specialization in many different areas, with some of the most popular being:
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Nurse practitioners can pursue specialization in many different areas, including:
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| Salary (Latest Data as of April 2026) | There are 155,540 physician assistants currently working in the U.S., according to the Bureau of Labor Statistics (BLS May 2024): Average salary: $65.82 per hour, or $136,900 per year
| There are 307,390 nurse practitioners working in the U.S., according to the Bureau of Labor Statistics (BLS May 2024): Average salary: $63.46 per hour, or $132,000 per year
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| Career Outlook (2024-2034) | The BLS forecasts that the need for physician assistants will grow 20 percent over the next decade, a rate that’s nearly seven times the national average. | The BLS forecasts that the need for nurse practitioners will grow 40 percent in the next decade, a rate that’s more than thirteen times the national average. |
| Professional Associations and Resources |
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Matt Zbrog
WriterMatt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about trends within the healthcare workforce, with a particular focus on the power of interdisciplinary teams. He’s also covered the crises faced by healthcare professionals working at assisted living and long-term care facilities, both in light of the Covid-19 pandemic and the demographic shift brought on by the aging of the Baby Boomers. His work has included detailed interviews and consultations with leaders and subject matter experts from the American Nurses Association (ASCA), the American College of Health Care Administrators (ACHCA), and the American Speech-Language Hearing Association (ASHA).